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Hepatitis B

There are several types of viral hepatitis: A, B, C, D, and E. Hepatitis B virus is very infectious and spreads from person to person through bodily fluids, including blood, semen and vaginal fluids. People who are infected with hepatitis B can develop an acute illness, in which they become sick soon after infection and either recover fully, or go on to carry the virus in their blood.

Introduction

Hepatitis B is a viral disease that attacks the liver.There are several types of viral hepatitis: A, B, C, D, and E. Hepatitis B virus is very infectious and spreads from person to person through bodily fluids, including blood, semen and vaginal fluids. People who are infected with hepatitis B can develop an acute illness, in which they become sick soon after infection and either recover fully, or go on to carry the virus in their blood. Other people do not become sick when they catch the infection but continue to carry the virus in their liver for many years. Over a long period of time this can cause serious complications with liver failure or liver cancer. Hepatitis B cannot be cured, but can be prevented with a vaccine.

How you get it

Hepatitis B can be spread through contact with blood and/or other body fluids of an infected person via; broken skin, open cuts or wounds, sexual contact, sharing drug needles, blood transfusion, and passed from infected mother to baby. Newborn babies of infected mothers can be infected via the birth canal.

People at high-risk of contracting hepatitis B include:

Non-immune children exposed to infected children , sharing blood in the playground

Injecting drug users

Heterosexuals with multiple partners

Men who have sex with men

Household contacts of infected persons

Healthcare and public safety workers who have exposure to blood in the workplace

People aged 25 years or over who are of Māori, Pacific Island or Asian ethnicity, and those born in Asia or the Pacific Islands are at higher risk of not being immune or of being exposed.

Chronic hepatitis B may be harder to detect as some infected people do not show signs or symptoms.

Treatment

Chronic infection can be treated with drugs like interferon and anti-viral medication. Patients with liver disease may be recommended for liver transplant. Liver cancer is almost always fatal.

The Hepatitis Foundation of New Zealand provides a free Hepatitis B Follow-up Programme with information, support and regular blood tests that are vital in managing a person with hepatitis B infection. We recommend visiting their website (www.hepatitisfoundation.org.nz) or phone free 0800 332 010.

Risks

Hepatitis B can be a life-long illness causing liver disease and liver cancer, particularly when infected as a young child or infant. Blood remains infective in those with a chronic hepatitis B infection and can infect others.

Adults are more likely to have severe acute illness than children in whom infection usually goes undetected.

Some people, especially children, become carriers of the virus (referred to as being ‘hepatitis B positive’):

Chronic infection occurs in 9 out of 10 infected newborns and up to half of children infected between the ages of 1-4 years

Liver cirrhosis occurs in 1 in 20 carriers, half of these will die from the condition

Liver cancer usually leads to death and occurs in 1 in 10 males who are chronically infected carriers and 1 in 20 females.

Prevention

There are effective vaccines available to prevent hepatitis B. The vaccine is provided free to all under 18 years and some contacts of an infectious person.

Contacts and family members of infected persons should practice strict hygiene measures, including covering open cuts and sores, not sharing toothbrushes, razors, towels or other objects that have come in contact with body fluids and blood, and clean up blood spillage on hard surfaces with household bleach.

Hepatitis B

Complications of disease

Infants and children are less likely to have symptoms than adults, but infants are more likely to become chronically infected and develop complications later in life

Liver inflammation for around 8 out of 10 adults; around 2 adults out of 10 will not have symptoms

Acute liver failure can require liver transplantation or lead to death

Chronic infection can lead to cirrhosis and liver cancer

Responses to vaccine

Responses are more common in adults than in children

Common responses

Nausea or diarrhoea

Rare responses

Hives

Itching

Temporary low platelet count

Muscle or joint pain

Abdominal pain and vomiting

As with any medicine, very rarely, severe allergic reactions occur following immunisation